Epidermoid inclusion cysts After APTOS thread insertion: case report with clinicopathologic correlates.

The APTOS threading procedure is a relatively new method in antifacial ptosis surgery. The reported cases present a small percentage of minor complications. A 57-year-old woman experienced scarring after APTOS threading. Scar biopsy showed an epidermoid inclusion cyst. Epidermoid inclusion cysts are a potential complication of APTOS threading. Proper surgical technique may reduce their likelihood.

An epidermoid cyst with atypical keratinocytes in the lowermost portion of the cyst wall.

We report on a 31-year-old Japanese female with an epidermoid cyst developed in the right inguinal region. The lesion was excised and drained by a surgeon. Since there was a local recurrence of the lesion within 2 months, the patient visited us, and the lesion was completely excised. Only the cells in the lowermost layer of the cyst wall showed dysplasia, which was characterized by irregular, and hyperchromatic nuclei with coarsely clumped nuclear chromatin pattern. However, solar elastosis was not observed, and spongiosis surrounding the atypical cells was present. In addition, melanophages were seen in the upper dermis. In conclusion, atypical keratinocytes in the lowermost portion of the cyst wall were deemed to be secondary to inflammation due to treatment by a surgeon rather than to development of both in situ and invasive squamous cell carcinomas in an epidermoid cyst.

Laser-assisted dermal grafting for the correction of cutaneous contour defects.

BACKGROUND: The correction of dermal loss as occurring in acne and other atrophic scars as well as the cosmetic correction of deep rhytides may be attainable by many techniques. When autologous tissue is desired by the patient or when a larger procedure is not desired then autologous dermal grafting is often a satisfactory solution. METHODS: Eleven patients had 32 dermal grafts implanted for cutaneous contour defects. Various methods of harvesting and implanting dermal grafts are described. A high-energy short-pulse CO2 laser is used to prepare the donor site. OBJECTIVE: Dermal grafts are an attempt to provide safe autologous and permanent correction for deeper cutaneous contour problems. RESULTS: Most patients achieve adequate correction of their contour defect. Complication rate is low although early in our experience epidermal cyst formation (2/32) and tethering (1/32) were seen. Suggestions for avoidance of these problems are offered. In two grafts resorption or partial resorption was seen. CONCLUSIONS: Dermal grafting is a useful adjunctive technique in the management of deeper acne scars, and rhytides. It seems to be a safe reproducible technique that should become part of the dermatologic surgeon's armamentarium.

Posttransplant epidermoid cysts secondary to small graft hair transplantation.

BACKGROUND: Epidermoid cysts sometimes result from small-graft hair transplantation. Although hair transplant surgeons are aware of this complication, it has not been reported to date. OBJECTIVE: Our purpose is to report the clinical and histological features of posttransplant epidermoid cysts. METHODS: Four patients with posttransplant cysts, and the histological features of two of these cysts, were reviewed. RESULTS: All cysts occurred at the site of a recent micro- or minigraft, and were small; one had become infected. Serial sectioning of one scalp biopsy showed a micrograft lying in the subcutaneous tissue in close proximity to an epidermoid cyst. The cyst apparently arose from the follicular infundibulum of the graft. CONCLUSION: Posttransplant epidermoid cysts are examples of epidermal inclusion cysts. They are treated by conservative excision, and may require drainage for secondary infection. Careful operative technique should prevent some of these cysts.